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1.
BMC Infect Dis ; 20(1): 194, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32138677

RESUMO

BACKGROUND: Hepatitis B virus disease is a potentially life-threatening liver infection and a major global health problem. It causes chronic infection and puts people at high risk of death from cirrhosis and liver cancer. WHO estimated 257 million people are living with hepatitis B virus (HBV) infection and in 2015 alone HBV resulted in to 887,000 deaths globally. We determined the prevalence and associated factors of hepatitis B virus infection among Antenatal Care (ANC) attendees in Gamawa Local Government Area, Bauchi State. METHODS: We conducted a descriptive cross-sectional, health facility-based study between March and April 2018. We used systematic random sampling technique to recruit 210 pregnant women aged 15-49 years. With a structured questionnaire, we interviewed the respondents and collected blood sample to test for hepatitis B surface antigen. We calculated frequencies, means, proportions, and tested for associations using Epi Info 7.2 and Microsoft Excel. RESULTS: The mean age of respondents was 24.5 ± 6.0 years; 112 (53%) of whom were younger than 25 years. All were married, 183 (87%) had no formal education and up to 190 (90%) were employed. Overall, 14 (6.7%) tested positive for HBsAg; women aged ≥35 years had the highest prevalence (10%). None with tertiary education tested positive and women married before 18 years had 13 (6.2%) prevalence. CONCLUSIONS: The prevalence of HBsAg among pregnant women in Gamawa LGA was 6.7% which is quite lower than the national prevalence reported. We recommended improved surveillance of HBV infection and screening of women attending ANC.

2.
BMC Pediatr ; 20(1): 114, 2020 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-32145745

RESUMO

BACKGROUND: Malnutrition is a major public health problem with short and long-term adverse effects on children particularly in middle and low-income countries. Three out of every ten under-five children are said to be stunted and 19.4% underweight in Nigeria. In Ebonyi State, between 2013 and 2015, the proportion of preschool children with chronic undernutrition rose from 16.2 to 20.6%. Little is documented about the nutritional status of school-age children in Ebonyi State and Nigeria. METHODS: We conducted a descriptive cross-sectional study among 780 children aged 6 to 12 years from 10 primary schools in Abakaliki metropolis. A multistage sampling method was used to select the participants. A pre-tested interviewer-administered structured questionnaire was used to collect information from the children and their parents. Body Mass Index (BMI), Z scores of the weight for age, BMI for age and height for age were obtained using the WHO AnthroPlus software. We estimated the prevalence of undernutrition, over-nutrition, underweight, thinness, stunting, overweight and obesity. RESULT: Out of 751 pupils that participated, 397 (52.9%) were females and 595 (79.2%) were in public schools. The overall prevalence of undernutrition was 15.7% and that of over-nutrition was 2.1%. The prevalence of underweight, thinness and stunting, overweight and obesity were 8, 7.2, 9.9, 1.4 and 0.7% respectively. The proportion of pupils who were thin was higher among males (8.7%), those attending public schools (8.6%) and those dwelling in rural parts of the metropolis (14.3%) compared to females (5.8%) private school attendees (1.9%) and urban dwellers (4.6%). Stunting was found to be higher among pupils attending public schools (11.8%) compared to those attending private schools (2.5%). The prevalence of stunting was 19.3% among the pupils residing in rural areas and 5% among the pupils living in urban areas of the metropolis. No pupil in private schools was underweight. Over-nutrition was not found among the pupils in rural areas. CONCLUSION: Both under and over nutrition exist in Abakaliki metropolis. Undernutrition is the more prevalent form of malnutrition among school age children in the metropolis.

3.
BMC Public Health ; 20(1): 217, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32050926

RESUMO

BACKGROUND: Lassa fever (LF) is an epidemic-prone zoonotic disease prevalent in Nigeria and Ebonyi State is a high burden area in Nigeria. Low risk perceptions have been reported to prevent appropriate preventive behaviours. We investigated the knowledge and risk perception of residents towards LF and determined the factors influencing their risk perception in communities that have reported confirmed cases of LF. METHODS: We conducted a cross-sectional study in the affected wards in Abakaliki Local Government Area (LGA). We interviewed 356 adult respondents recruited across 6 settlements in 3 of the affected wards through multistage sampling technique. Information on participants' knowledge of LF, their risk perception using the health belief model as well as factors influencing risk perception were obtained. We estimated the proportions of respondents with good knowledge and high risk perceptions. We also explored the relationship between risk perception, knowledge and sociodemographic characteristics using Chi Square and logistic regression at 5% level of significance. RESULTS: The mean age of the participants was 33.3 ± 12.2 years, 208 (63.2%) were females, 230 (69.9%) were married and 104 (31.6%) had attained tertiary education. Though 99.1% were aware of LF infection, 50.3% among them had poor knowledge of LF symptoms and risk factors, 92.9% had high risk perception of severity, 72.4% had a high feeling of susceptibility towards LF infection, 82.5% had a high perceived self-efficacy towards LF infection, 63.5% had a low perceived benefit of LF preventive practices and 31.8% had high perceived barrier towards LF preventive practices. Good knowledge of LF was the only significant factor influencing risk perception; perceived severity: (COR: 3.0, 95%CI: 1.2-7.8), perceived susceptibility (AOR: 2.0, 95%CI: 1.25-3.3) and perceived benefit (COR: 2.1, 95%CI: 1.3-3.3). CONCLUSIONS: Good knowledge of LF influences risk perception towards LF which has great import on LF preventive practices. A gap exists in the content and acceptance of LF risk communication information in the LGA. There is a need to review the risk communication messages in the state towards LF in the community with special focus on the males and younger population.

4.
Malar J ; 19(1): 2, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31898498

RESUMO

BACKGROUND: Presumptive diagnosis and prescription of anti-malarial medicines to malaria rapid diagnostic test (RDT)-negative patients is a common practice among health care workers (HCWs) in Nigeria. There is paucity of data on HCWs adherence to RDT result in Sokoto metropolis, Nigeria. The study was conducted to determine HCWs adherence to malaria test result and the influencing factors. METHODS: A cross-sectional study was conducted among 262 HCWs selected by multistage sampling technique from primary and secondary health facilities in Sokoto metropolis. Data on demographic characteristics, adherence to RDT result and its influencing factors were collected from the HCWs. Adherence was categorized into good if adherence score is ≥ 4 and poor if otherwise. Chi-squared test was used to test association between adherence to test results and patients' fever presentation, expectation to be given anti-malarials, prior HCWs' case management training, among others. Independent predictors of adherence to RDT results were ascertained. RESULTS: Respondents' mean age was 33.5 ± 7.9 years, 190 (72.5%) worked in Primary Health Care facilities, 112 (42.8%) were Community Health Workers, 178 (67.9%) had National Diploma Certificate. The median years of practice was 5.0 (IQR: 3-10) years, while 118 (45.0%) had at most 4 years of practice. Overall, 211 (80.5%) had good adherence to RDT results. About 108 (89.3%) of HCWs who had training on malaria case management and 35 (89.7%) certificate holders had good adherence to RDT results. Predictors of adherence to test results were presence of fever in the patient [adjusted odds ratio (aOR): 2.53, 95% confidence interval (CI) 1.18-5.43], patients' expectation to be given anti-malarial medicines by the HCW (aOR: 3.06, 95% CI 1.42-6.58) and having been trained on malaria case management (aOR: 2.63; 95% CI 1.26-5.44). CONCLUSION: High level of adherence to RDT results among HCWs in Sokoto metropolis could be attributed to prior malaria case management training and HCWs' confidence in the national treatment guidelines. Continual training and supportive supervision of HCWs on malaria case management might optimize the current level of adherence to RDT results in Sokoto metropolis, Nigeria. Similarly, patients/caregivers' health education could aid better understanding of the need for anti-malarials thus reducing unnecessary demand.

5.
BMC Pregnancy Childbirth ; 19(1): 457, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791271

RESUMO

BACKGROUND: Malaria in pregnancy has adverse effects on maternal and child health. Intermittent preventive treatment (IPTp) with three doses of Sulfadoxine/Pyrimethamine is an effective preventive measure for malaria in pregnancy. However, 24.0% of women use this prophylactic regimen in Ebonyi State. Previous studies have focused on the level of uptake with less attention given to factors influencing uptake. Therefore, we examined the predictors of IPTp uptake in the last pregnancy among women in Ebonyi State, Nigeria. METHODS: This was a community-based cross-sectional study among 340 women of reproductive age selected using multistage sampling technique. A semi-structured interviewer administered questionnaire was used to collect data on socio-demographic characteristics of respondents, IPTp uptake and reasons for not taking IPTp. Adherence was judged adequate if three or more doses of IPTp were taken, otherwise inadequate. Data were analyzed using descriptive statistics, Chi- square test and logistic regression model at 5% level of significance. RESULTS: Mean age of respondents was 28.8 ± 5.2 years, 96.5% were married, 19.4% had tertiary education, and 11.2% were from polygamous family. Uptake of IPTp was 74.2%. The level of IPTp uptake was 12.5 and 41.0% among women with no formal and tertiary education respectively. A similar pattern of IPTp uptake was observed among women from monogamous (38.0%) and polygamous (39.5%) families. Women education, husband education and family type were associated with uptake of IPTp, however only husband education remained a predictor of uptake. Women whose husband had secondary education (aOR = 4.1, 95%CI: 1.66-10.06) and tertiary education (aOR = 4.8, 95%CI: 1.76-12.90) were more likely to have IPTp uptake than those whose husbands had below secondary education. CONCLUSION: Adequate IPTp uptake among women in their last pregnancy was below WHO recommendation. Intervention aimed at improving couple's education could facilitate increase in IPTp uptake in Ebonyi State.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31818711

RESUMO

INTRODUCTION: Nigeria ranked 7th among the high TB burden nations globally and second most endemic in Africa. There are several highly effective interventions available for tuberculosis control. Operational challenges have been reported to interfere with the success of these interventions. This review was conducted to ascertain the treatment outcome using the Directly Observed Short Course Strategy implemented in the hospital. METHODS: A retrospective review of the Tuberculosis treatment was conducted in former Ebonyi State Teaching Hospital and Federal Teaching Hospital from 2008 to 2014 as part of the departmental critique of patients' clinical care and tuberculosis control activities. Using the facility's TB treatment register, information on the patient's demography, clinical characteristics and treatment outcome was extracted. The data were analyzed using Epi Info version 7.2. Frequencies and proportions were calculated. RESULTS: A total of 1070 cases were reviewed with majority 491 (45.9%) belonging to 25-44 years age group. There were 585 (54.7%) males and 68 (11.6%) paediatrics. Pulmonary tuberculosis (667, 62.3%) was the most common presentation. Among those that did sputum smear AFB, 53.2% were smear negative. In all, 91.2% of the cases were treatment naïve, 59.1% were HIV negative at beginning of their treatment while 8% had unknown HIV status. Of the treatment outcome, 40.5% were classified as treatment completed, 16.0% cured, 17.4% of the cases defaulted while 14.1% of the cases died on treatment. These patients were often referred from primary and secondary level hospitals. CONCLUSIONS: The cure rate was very poor and treatment default rate high. The high default rate could be due to the referral nature of the hospital. The treatment success rate of 56.5% is still far below the national target of 85% treatment success rate for effective tuberculosis control. An operational research is recommended to elicit the root causes of low treatment success rate and high patient default rate.

7.
Ethiop J Health Sci ; 29(4): 487-494, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31447522

RESUMO

Background: Nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization is of public health concern due to increased risk of developing invasive infections and the therapeutic challenges. This concern is more among the vulnerable group. We determined the prevalence and associated risk factors of MRSA nasal carriage among children in a tertiary hospital in Nigeria. Method: We conducted a hospital-based, cross-sectional study among 300 children attending the outpatient clinic of a tertiary hospital recruited through systematic sampling technique. An interviewer-administered, structured questionnaire was used to obtain sociodemographic characteristics and exposure factors. Nasal swabs samples were collected and inoculated on mannitol salt agar and subcultured on nutrient agar to isolate Staphylococcus aureus. We used the conventional Polymerase Chain Reaction (PCR) technique to detect the presence of mecA gene for MRSA. We calculated the prevalence, prevalence odds ratio to determine risk factors for MRSA acquisition at 5% level of significance. Results: The median age was 1.7 years (6 months-16 years). Males accounted for 60.7%, and 75% of the participants were under 5 years. Staphylococcus aureus colonization was found in 36.3% of the participants while 5.3% of the participants had MRSA identified by detecting the mecA gene. History of recent surgery in the last six months was the only independent predictor of nasal MRSA colonization among the participants (aOR=12.5; 95%CI: 2.7-50.0.). Conclusion: The high prevalence of MRSA colonization observed among the children in this study suggests the need to consider screening children with history of previous surgery as infection control and prevention intervention for MRSA.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Mucosa Nasal/microbiologia , Infecções Estafilocócicas/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/microbiologia
8.
BMC Infect Dis ; 19(1): 654, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331280

RESUMO

BACKGROUND: Retaining patients on antiretroviral treatment in care is critical to sustaining the 90:90:90 vision. Nigeria has made some progress in placing HIV-positive patients on treatment. In an effort to increase access to treatment, ART decentralization has been implemented in the country. This is aimed at strengthening lower level health facilities to provide comprehensive antiretroviral treatment. We determined the level of retention and adherence to treatment as well as the associated factors among private and public secondary level hospitals in Anambra State. METHOD: We conducted a cross-sectional study among patients who had taken antiretroviral treatment for at least one complete year. A structured questionnaire and patient record review were used to extract information on patient adherence to treatment, and retention in care. Adherence to treatment was ascertained by patient self-report of missed pills in the 30 days prior to date of interview. Retention in care was ascertained using the 3-month visit constancy method reviewing the period spanning 12 months prior to the study. RESULT: We found a comparable level of retention in care (private 81.1%; public 80.3%; p = 0.722). However, treatment adherence was significantly higher amongst participants in the private hospitals compared to those in the public hospitals (private: 95.3%; public: 90.7%; p = 0.001). Determinants of good retention in the private hospitals included disclosure of one's HIV status (AOR: 1.94, 95% CI: 1.09-3.46), being on first-line regimen (AOR: 3.07, 95% CI: 1.27-7.41), whereas being on once-daily regimen (AOR: 0.58, 95% CI: 0.36-0.92), and being currently married (AOR: 0.54 95% CI: 0.32-0.91) determined poor retention. In the public hospitals, only disclosure (AOR: 3.12 95% CI: 1.81-5.56) determined good retention, whereas, spending less than N1000 on transport (AOR: 0.230 95% CI: 0.07-0.78) and residing in a rural area (AOR: 0.64 95% CI: 0.41-0.99) determined poor retention. None of the factors determined adherence. CONCLUSION: Retention in care was high and comparable among the different hospital types and HIV disclosure status was an important factor relating to retention in care. The other factors that determined retention were however different at public and private hospitals. The HIV program manager should consider these variations in designing programs to improve patient retention in care and adherence to treatment.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Retenção nos Cuidados/estatística & dados numéricos , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Adulto , Estudos Transversais , Feminino , Hospitais Privados/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Nigéria , Cooperação do Paciente/estatística & dados numéricos , Inquéritos e Questionários
9.
Pan Afr Med J ; 33: 17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31312333

RESUMO

Introduction: family planning programmes have helped in increasing the prevalence of contraceptive use and reducing total fertility rate in developing countries from six to three births per woman. However, its uptake is lower in the rural areas compared to urban areas. This study seeks to elucidate the effect of community mobilisation on awareness, approval and use of family planning among women of reproductive age in the rural areas of Ebonyi state, Nigeria. Methods: we conducted a quasi-experimental study among women aged 15 to 49 years in two rural communities in Ebonyi state. Using simple random method, we recruited 484 women for the study. We used pre-tested interviewer-administered questionnaire to collect information from the participants. Community awareness and distribution of information, education and communication materials were carried out within one month. We estimated the effect of the intervention on the level of awareness, approval and uptake of family planning methods. Results: level of awareness increased by 19% (p<0.001) while uptake of family planning increased by 16.7% (p<0.001) in the intervention group. The approval rate was higher in the intervention group compared to the control group (p=0.008). The most commonly used method of family planning was the natural method in intervention and control arms. Conclusion: although uptake of family planning increased significantly in the study population, the rate is generally low. Given the critical role of the community in family planning programmes, community mobilisation may be deployed to increase uptake of family planning in similar rural communities.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Serviços de Planejamento Familiar/métodos , Conhecimentos, Atitudes e Prática em Saúde , População Rural/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria , Educação Sexual/métodos , Inquéritos e Questionários , Adulto Jovem
11.
J Glob Antimicrob Resist ; 17: 291-295, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30668994

RESUMO

OBJECTIVES: Antimicrobial prescribing practices and use contribute to the growing threat of antimicrobial resistance (AMR) to global health. Information on antimicrobial prescribing and use are lacking in most developing countries, including Nigeria. This information is crucial for antimicrobial stewardship programmes, an effective tool in minimising AMR. This study was performed to gather baseline information on antimicrobial prescribing practices in Nigeria. METHODS: A cross-sectional survey was conducted on all inpatients of a tertiary hospital in South East Nigeria. All patients on admission on the day of the survey formed the study population. A standardised questionnaire, web-based data entry and validation process designed by the University of Antwerp, Belgium, were adopted. Information on basic patient demographics, antimicrobial agents used, indication for treatment, laboratory data prior to treatment and stop/review date was collected. RESULTS: Of 220 inpatients surveyed, 78.2% were receiving at least one antimicrobial agent. The highest prevalence of antimicrobial use was in the ICU (100%), adult surgical ward (82.9%) and paediatric medical ward (82.9%). Agents used were mainly third-generation cephalosporins (ceftriaxone 25.1%) and nitroimidazole (metronidazole 24.6%). Antimicrobial prescription was empirical (91.1% in medical wards, 96.8% in surgical wards and 100% in ICU). There was limited use of guidelines but clear documentation of stop/review dates and reasons for antimicrobial use. CONCLUSION: Although a majority of antimicrobial prescriptions were made with indications, they were mostly prescribed empirically and the majority of prescriptions were parenteral formulations. There is a need to develop antibiotic guidelines, to educate prescribers on antimicrobial stewardship and to encourage targeted prescription.

12.
PLoS One ; 13(10): e0206499, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30365560

RESUMO

INTRODUCTION: HIV and AIDS care requires frequent visits to the hospital. Patient satisfaction with care services during hospital visits is important in considering quality and outcome of care. Increasing number of patients needing treatment led to the decentralization of care to lower level hospitals without documented patient perception on the quality of services. The study determined and compared patient satisfaction with HIV and AIDS care services in public and private hospitals and identified the factors that influence it. METHOD: This was a cross-sectional comparative study of patients receiving antiretroviral treatment in public and private hospitals in Anambra State. The sampling frame for the hospitals consisted of all registered public and private hospitals that have rendered antiretroviral services for at least one year. There were three public urban, nine public rural, eleven private urban and ten private rural hospitals that met the criteria. One hospital was selected by simple random sampling (balloting) from each group. Out of a total of 6334 eligible patients (had received ART for at least 12 months), 1270 were recruited by simple random sampling from the hospitals proportionate to size of patient in each hospital. Adapted, validated and pretested Patient Satisfaction Questionnaire (PSQ18) was interviewer-administered on consenting patients as an exit interview. A Chi-square test and logistic regression analysis were conducted at 5% level of significance. RESULT: There were 635 participants each in public and private hospitals. Of the 408 patients who had primary education or less, 265(65.0%) accessed care in public hospitals compared to 143(35.0%) who accessed care in private hospital (p<0.001). Similarly, of the 851 patients who were currently married, 371 (43.6%) accessed their care in public compared to 480 (56.4%) who accessed care in private (p<0.001). The proportion of participants who were satisfied were more in public hospitals (71.5%) compared to private hospitals (41.4%). The difference in proportion was statistically significant (χ2 = 116.85, p <0.001). Good retention in care [AOR: 2.3, 95%CI: 1.5-3.5] was the only predictor of satisfaction in public hospitals while primary education [adjusted odds ratio (AOR); 2.3, 95%CI: 1.5-3.4], residing in rural area [AOR: 2.0, 95%CI: 1.4-2.9], and once-daily dosing [AOR: 3.2, 95%CI: 2.1-4.8] were independent predictors of patient' satisfaction among private hospital respondents. CONCLUSION: Satisfaction was higher among patients attending public hospitals. Patient's satisfaction was strongly associated with retention in care among patients in public hospitals. However, in private hospitals, it was influenced by the patient's level of education, place of residence, and antiretroviral medication dosing frequency.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Infecções por HIV/tratamento farmacológico , Satisfação do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Adulto , Antirretrovirais/uso terapêutico , Estudos Transversais , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hospitais Privados/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Percepção , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e Questionários
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